Retreatment Flashcards
success rate of endodontic therapy
has been reported all over the place
from 94.8% to as low as 53%
follow up in years in the studies is an important aspect
success of retreatment
80 ish(83%)
so re-treatment can have a lower success rate
follow up period for retreatment
better results if longer because sometimes healing is longer
healing in progress –> healing complete
how to/ ways to evaluate endodontic success
- clinical success
- radiographic success
- histological success
- follow-up period
clinical success is represented by?
ABSENCE OF SIGNS AND SYMPTOMS
- no spontaneous pain
- negative o percussion
- negative to palpation
- absence of sinus tract
- absence of swelling
radiographic success
contours, width, and structure of PDL are normal
- follow PDL space and want intact lamina dura
cannot be success on its own
follow-up period importance
how long endodontic treatment should be followed up?
1 year is minimum!! -
follow up period up to 4 years is desirable
(2-3 weeks if dealing with sinus tract )
when assessing tooth that ay need re-treatment what is important to ask and do?
ask when it was treated
PROBE– eliminate perio as reason
etiology of failure
presence of infection in root canal system
(Usually limited to root canal space) – but if established can extend
BACTERIAL INFECTION
triad of success
- diagnosis
- cleaning, shaping, and 3-D obturation, (good treatment)
- coronal restoration
diagnosis importance
radiographs and make sure this is right
- clinical and radiographic examsm
like signs and sympoms point to endo but actually could be something like a palatal groove and localized bone loss – which is a perio problem
radiogrpahic importance of diagnosis after treatment
look back at radiographs – could think failing but actually getting better when compared to old radiographs
goal of cleaning shaping and obturating
- eliminate organic material and bacteria from root canal system
- prevent future bacterial contamination and infection
- seal any remaining bacteria within the root canal system (place a restoration as soon as practically possible)
have to get all canals
number one failure for RTC
missed a canal
breakdown of post endodontic coronal restroration
- temp restoration
- post preparation
- proper coronal restoration
- quality of coronal restoration
temporary restoration requirements and breakdown
- must have divergent access prep
- thickness must be 4mm (depth - inside access cavity)
- cavit temporary recommended
- immediate permanent restoration
describe post preparation
- use of rubber dam
- maintain 5mm of apical gutta percha – so dont compromise the apical seal
- heat carrier followed by rotary instrument (gates glidden burs)
amount of gutta percha to leave if preparing for a post space
maintain 5mm of apical gutta percha – so dont compromise the apical seal
(ideally) to establish a good apical seal
failure to adequately and properly restore endodontically treated teeth may result in what?
vertical fracture of tooth structure
clinical success rate with maxillary anteriors with crown and no crown
ateriors
crown
- 87.5%
no crown
85.4%
clinical success rate of maxillary premolars with crown and no crown
crown
- 93.9%
no crown
- 56%
clinical success rate of maxillary molars with crown and no crown
crown
- 97.8%
no crown
-50%
why is the success rate go down so much without crown restoration
FRACTURE – so all restoration teeth with endo need cuspal coverage
coverage requirements in anterior vs posterior
all posterior teeth that have received endodontic treatment require CUSPAL COVERAGE
not all anterior teeth require crowns
